Successful treatment of life-threatening human herpesvirus-6 encephalitis with donor lymphocyte infusion in a patient who had undergone human leukocyte antigen-haploidentical nonmyeloablative stem cell transplantation

Transplantation. 2004 Mar 27;77(6):835-8. doi: 10.1097/01.tp.0000119603.59880.47.

Abstract

Background: Encephalitis as the result of human herpesvirus (HHV)-6 is usually fatal when it is resistant to antiviral drugs.

Methods: We describe a patient who developed HHV-6 encephalitis after human leukocyte antigen-haploidentical transplantation using a reduced intensity regimen.

Results: The patient developed severe disorientation, amnesia, and tremors on day 28. Magnetic resonance imaging of the brain revealed limbic encephalitis, and the cerebrospinal fluid sample was positive for only HHV-6 in polymerase chain reaction analysis. Neither ganciclovir nor foscarnet was effective. The patient recovered from the critical condition of HHV-6 encephalitis after donor lymphocyte infusion (DLI). Almost all of his symptoms resolved, polymerase chain reaction tests for HHV-6 in the cerebrospinal fluid were negative, and magnetic resonance imaging findings were normal.

Conclusions: This is the first report of DLI as a treatment for HHV-6 encephalitis and the first report of DLI from an human leukocyte antigen-haploidentical donor as a treatment for life-threatening viral infection.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain / pathology
  • Brain / virology
  • Encephalitis, Viral / therapy*
  • Graft vs Host Disease / prevention & control
  • HLA Antigens / immunology*
  • Herpesvirus 6, Human*
  • Histocompatibility Testing
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lymphocyte Transfusion*
  • Lymphoma, B-Cell / pathology
  • Lymphoma, B-Cell / therapy
  • Magnetic Resonance Imaging
  • Male
  • Roseolovirus Infections / immunology*
  • Roseolovirus Infections / therapy*
  • Stem Cell Transplantation*
  • Tacrolimus / therapeutic use
  • Tissue Donors

Substances

  • HLA Antigens
  • Immunosuppressive Agents
  • Tacrolimus